AB0544 LEFT VENTRICULAR GEOMETRY ABNORMALITIES ASSOCIATED WITH DISEASE ACTIVITY IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS
Authors: N. Guajardo-Jauregui, J. R. Azpiri-López, I. J. Colunga-Pedraza, D. Á. Galarza-Delgado, A. Cárdenas, A. N. Garza-Cisneros, A. Garcia-Heredia, M. A. Balderas-Palacios, A. B. Rodriguez-Romero
Journal: Annals of the Rheumatic Diseases (2022)

Background Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease. Patients with SLE have higher risk of developing a cardiovascular event than the general population (1), with multiple factors contributing to this increased risk, including systemic inflammation (2). Objectives To compare the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and other disease characteristics of SLE patients with and without left ventricular (LV) geometry abnormalities. Methods This was a cross-sectional study nested of a SLE cohort. We recruited patients with SLE diagnosis, according to the 2019 EULAR/ACR classification criteria, aged ≥ 18 years. Patients with a previous cardiovascular event, another connective tissue disease or pregnancy were excluded. A transthoracic echocardiogram was performed by two certified echocardiographers blinded to clinical information. Disease activity was assessed with SLEDAI. SLE patients with LV geometry abnormalities were included in this study and matched by age and gender to SLE patients with normal LV geometry by a certified rheumatologist blinded to clinical information. Comparisons were done with Chi-square test or Fisher’s exact test for qualitative variables, and Student’s T test or Mann-Whitney’s U test for quantitative variables. A p -value &lt; 0.05 was considered statistically significant. Results A total of 44 SLE patients were included, 22 patients with LV geometry abnormalities and 22 patients with normal LV geometry. Mean age of SLE patients with LV geometry abnormalities was 35.1 ± 12.2 years, compared to 35.4 ± 9.4 years of SLE patients with normal LV geometry, p = 0.923. The rest of demographic characteristics are shown in Figure 1. When evaluating disease characteristics, the SLEDAI score was significantly higher in SLE patients with LV geometry abnormalities (26.45 vs 17.33, p = 0.016) (Table 1). Table 1. Comparison of disease characteristics of SLE patients with and without LV geometry abnormalities. Variables Patients with LV geometry abnormalities (n=22) Patients with normal LV geometry (n=22) p -value Disease duration, months, median (IQR) 60.0 (12.7-150) 72.0 (43.0-117.7) NS SLEDAI, median (IQR) 10.5 (4.0-15.0) 6.0 (2.0-9.0) 0.016 CRP, mg/dl, median (IQR) 0.52 (0.33-1.29) 0.60 (0.41-0.85) NS ESR, mm/h, median (IQR) 26.0 (13.2-34.2) 29.0 (8.7-58.5) NS ANA titers, median (IQR) 640 (160-3200) 480 (160-5120) NS Anti-dsDNA, median (IQR) 0 (0-160) 0 (0-200) NS C3, mean ± SD 94.6 ± 31.4 100.5 ± 46.1 NS C4, median (IQR) 13.6 (9.8-14.9) 12.8 (6.4-19.8) NS Anti-Ro, median (IQR) 4.5 (2.0-190.5) 3.5 (2.0-82.2) NS Anti-La, median (IQR) 2.0 (2.0-4.0) 2.0 (2.0-3.0) NS Hydroxychloroquine, n (%) 20 (90.9) 18 (81.8) NS Glucocorticoids, n (%) 19 (86.4) 17 (77.3) NS SLE, systemic lupus erythematosus; LV, left ventricular; NS, not significant; SLEDAI, Systemic Lupus Erythematosus Disease Activity Index; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; ANA, antinuclear antibodies; anti-dsDNA, anti-double stranded DNA. Conclusion SLE patients with LV geometry abnormalities had higher SLEDAI score than patients with normal LV geometry. A transthoracic echocardiogram may be useful detect early cardiovascular abnormalities in SLE patients with high disease activity, and therefore should be considered as part of the cardiovascular evaluation of these patients. References [1]Chen J, Tang Y, Zhu M, et al. Heart involvement in systemic lupus erythematosus: a systemic review and meta-analysis. Clin Rheumatol 2016; 35:2437–48. [2]Kao AH, Sabatine JM, Manzi S. Update on vascular disease in systemic lupus erythematosus. Curr Opin Rheumatol 2003; 15:519–27. Disclosure of Interests None declared